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Semaglutide vs tirzepatide dose chart: how do the doses compare?

Every dose step for Ozempic, Wegovy, Rybelsus and Mounjaro as sold in India, what each step costs, and why the milligrams can't be swapped.

GLP Guidebook teamPublished 14 Oct 202611 min read29 sourcesWritten from published sources
What we checked29 sources, each one opened and linked to the sentence it supportsLast checked 14 Oct 2026 · Next review due 14 Apr 2027 · How we write

Written for India. Reading from elsewhere? Other country versionsComing soon

The short answer

Semaglutide and tirzepatide doses can't be swapped milligram for milligram. Semaglutide injections start at 0.25 mg a week and go up to 1 mg (Ozempic) or 2.4 mg (Wegovy) in India. Tirzepatide (Mounjaro) starts at 2.5 mg a week and can reach 15 mg, in steps at least 4 weeks apart.

At a glance

SemaglutideTirzepatide
Medicine and makerMade by Novo Nordisk as Ozempic, Wegovy and Rybelsus; Emcure sells Novo's Poviztra. Indian companies have sold their own brands since March 2026.7,13,15Made by Eli Lilly as Mounjaro; Cipla sells Lilly's Yurpeak.14
Approved in India forOzempic and Rybelsus: type 2 diabetes. Wegovy: weight management, teens 12+ above 60 kg, and MASH. Generic brands vary.7,9,11,12Mounjaro: type 2 diabetes and long-term weight management in adults8
How it is takenWeekly injection (Ozempic, Wegovy); daily tablet (Rybelsus)1,2,5Weekly injection: KwikPen of 4 doses, or single-dose vial3,16
Dose stepsOzempic 0.25 → 0.5 → 1 mg. Wegovy 0.25 → 0.5 → 1 → 1.7 → 2.4 mg. Rybelsus 3 → 7 → 14 mg a day.1,2,52.5 mg, then up 2.5 mg at a time, at least 4 weeks apart, to 15 mg at most3
Weight change in its main trial, with the main harmOver 68 weeks in STEP 1: −14.9% of body weight on Wegovy 2.4 mg, −2.4% on a dummy injection. Nausea in the EU label's pooled STEP 1–4 trials: 44 in 100 on Wegovy, 16 in 100 on a dummy injection.18,6Over 72 weeks in SURMOUNT-1: −15.0% to −20.9% of body weight on tirzepatide 5 to 15 mg, −3.1% on a dummy injection. Nausea in the US Zepbound label's pool of SURMOUNT-1 and -2: 25 to 29 in 100 on tirzepatide, 8 in 100 on a dummy injection.19,4
Most common side effects (EU label bands)Very common (more than 1 in 10) on the EU Wegovy label: nausea, vomiting, diarrhoea, constipation, stomach pain6Very common (more than 1 in 10) on the EU Mounjaro label: nausea, diarrhoea; vomiting, stomach pain and constipation in weight trials17
MRP in IndiaOzempic pen of 4 doses ₹5,660 to ₹9,100; at 1 mg about ₹9,858 a month, ₹1,18,300 a year. Wegovy pen ₹5,660 to ₹16,400; at 2.4 mg about ₹17,767 a month, ₹2,13,200 a year. Rybelsus 30 tablets: ₹9,900 (7 mg), ₹10,884 (14 mg).7,10,21Mounjaro KwikPen of 4 doses ₹13,125 to ₹25,781; at 5 mg about ₹17,773 a month, ₹2,13,278 a year; at 15 mg about ₹27,929 a month, ₹3,35,153 a year.20
Insurance in IndiaUsually not covered: standard policies pay for hospital stays, not outpatient medicines25Usually not covered, for the same reason25

MRP is the printed maximum retail price, checked against our price index on 11 Oct 2026. A month is 52 ÷ 12 ≈ 4.3 weekly doses; a year is 52 doses. Dose steps are from the US labels. The weight rows come from separate trials against a dummy injection, so they can't be compared directly; the head-to-head trial is below. Medicines are in alphabetical order, not ranked.

Before you go further
  • This chart is not a schedule to follow. A doctor sets each step, and many people stay on a lower dose.
  • All these medicines are prescription-only. A government statement on 1 Apr 2026 said only endocrinologists, internal-medicine specialists and cardiologists can prescribe them.26 CDSCO expert-committee minutes attach a similar condition to some approvals (endocrinologist or internal-medicine specialist), but we found no rule covering every brand.27,28
  • Every dose has side effects and risks: Guide 5: Side effects and risks.
On this page
  1. Why can't the doses be compared milligram for milligram?
  2. What are the semaglutide dose steps?
  3. What are the tirzepatide dose steps?
  4. Do higher doses bring more weight loss and more side effects?
  5. What does each dose cost in India?
  6. What if a dose is missed or a step is hard to bear?
  7. Which one? What does a doctor weigh?
  8. Questions people ask
  9. How we researched this

Why can't the doses be compared milligram for milligram?

Semaglutide and tirzepatide are different molecules, so 1 mg of one does not do what 1 mg of the other does. None of the labels gives a conversion.

Semaglutide copies one gut hormone, GLP-1. Tirzepatide acts on two, GIP and GLP-1.2,3 Each medicine has its own ladder, set in its own trials.2,3

Even the same medicine doesn't convert simply. Only about 0.4% to 1% of a Rybelsus tablet is absorbed, so the daily tablet dose is far higher than the weekly injection.5 The US label lets someone on a 0.5 mg Ozempic injection move to 7 or 14 mg Rybelsus.5 It also says Rybelsus and the newer US Ozempic tablets are "not substitutable on a mg-to-mg basis".5

The trials that compared the two medicines gave each its own doses. SURPASS-2, in type 2 diabetes, set tirzepatide 5, 10 or 15 mg against semaglutide 1 mg.23 SURMOUNT-5, in obesity, used the highest dose each person could tolerate: tirzepatide 10 or 15 mg, or semaglutide 1.7 or 2.4 mg.24 Both were paid for by Eli Lilly, which makes Mounjaro.23,24

What are the semaglutide dose steps?

Both weekly semaglutide injections start at 0.25 mg for 4 weeks. Ozempic then settles at 0.5 or 1 mg in India; Wegovy climbs every 4 weeks to 2.4 mg.

  • Ozempic, for type 2 diabetes. 0.25 mg a week for 4 weeks, then 0.5 mg. If blood sugar needs more control after at least 4 weeks, 1 mg.1 The US label goes on to 2 mg, but India sells 0.25, 0.5 and 1 mg.1,7 The label lists 0.25 mg as a starting dose; the doses to stay on are 0.5, 1 or 2 mg.1 More in What are the Ozempic dose steps?
  • Wegovy, for weight. 0.25, 0.5, 1 and 1.7 mg, 4 weeks each, then 2.4 mg from week 17, or 1.7 mg.2 India sells all five strengths.13 The US label adds 7.2 mg, not sold here.2 Poviztra, Novo's second brand sold by Emcure, comes in the same five strengths.15
  • Rybelsus, a daily tablet for type 2 diabetes. 3 mg a day for 30 days, a starting dose the label says "is not effective" for blood sugar. Then 7 mg, and 14 mg from day 61 if needed.5 India has approved all three strengths.9 See Is there an Ozempic tablet?
  • Indian generic semaglutide. Brands from Indian companies have their own approvals, some for diabetes and some for weight, so the strengths differ by brand.7 India's semaglutide brands lists them.
The fastest dose steps each label allows, weeks 1 to 20
Weekly injections · mg per weekly dose · blue = semaglutide, green = tirzepatide · darker = higher dose of that medicine only. Boxes in the same column are the same week, not equal doses.
Ozempic (semaglutide), type 2 diabetes
0.25 mg0.5 mg1 mgif needed1 mg1 mgtop in India
Wegovy (semaglutide), weight
0.25 mg0.5 mg1 mg1.7 mg2.4 mgor stay 1.7
Mounjaro (tirzepatide)
2.5 mgstart only5 mg7.5 mg10 mg12.5 mg15 from wk 21
Wk 1–4Wk 5–8Wk 9–12Wk 13–16Wk 17–20
The colours compare steps within one medicine only: a darker box on one row is not "stronger" than a box on another row. Each step is the earliest the US label allows; Ozempic and Mounjaro only go up if more control is needed, and many people stay on a lower dose. Sources: Ozempic US label (May 2026), Wegovy US label (June 2026), Mounjaro US label (August 2026), Zepbound US label (August 2026). Checked 14 October 2026.1,2,3,4

What are the tirzepatide dose steps?

Mounjaro starts at 2.5 mg a week for 4 weeks. It can go up by 2.5 mg after at least 4 weeks on each dose, to 15 mg at most.

The 2.5 mg dose is only for starting. The doses to stay on, called maintenance doses, are 5, 10 or 15 mg on the US Zepbound label, the weight brand of the same tirzepatide.4 The label adds that if a dose isn't tolerated, a lower maintenance dose can be considered.4

In India, Mounjaro comes as a KwikPen holding 4 weekly doses, in six strengths from 2.5 to 15 mg.20 Single-dose vials are listed at 2.5 and 5 mg.16 Yurpeak, Lilly's tirzepatide sold by Cipla, comes in the same six strengths.14 Mounjaro doses explained goes step by step, and What is the maintenance dose? covers the dose people stay on.

Do higher doses bring more weight loss and more side effects?

In the trials, higher doses brought more weight loss on average, and more people stopped because of stomach side effects.

Tirzepatide. In SURMOUNT-1, adults without diabetes lost 15.0% of their weight on 5 mg, 19.5% on 10 mg and 20.9% on 15 mg over 72 weeks, against 3.1% on a dummy injection.19 In the US Zepbound label's pool of SURMOUNT-1 and SURMOUNT-2, stomach side effects made 1.9 in 100 stop on 5 mg, 3.3 in 100 on 10 mg and 4.3 in 100 on 15 mg, against 0.5 in 100 on the dummy.4 For a 90 kg (198 lb) person, those averages are about 14, 18 and 19 kg (30, 39 and 41 lb).

Semaglutide. STEP 2 tested 2.4 mg and 1 mg in 1,210 adults with type 2 diabetes for 68 weeks.22 Weight fell 9.6% on 2.4 mg against 3.4% on a dummy injection.22 Stomach side effects hit 64 in 100 on 2.4 mg, 58 in 100 on 1 mg and 34 in 100 on the dummy.22

Head to head. In SURMOUNT-5, weight fell 20.2% on tirzepatide and 13.7% on semaglutide over 72 weeks, at the highest dose each person could tolerate.24 Wegovy vs Mounjaro covers that trial and its side effects.

RisksThe risks, in brief
  • Stomach effects are the most common, and they come mostly while the dose goes up.4,2
  • Pancreatitis (an inflamed pancreas) and gallbladder problems are warnings on the labels for both medicines.1,3
  • Low blood sugar is more likely when either is taken with insulin or a sulfonylurea, a type of diabetes tablet.1,3
  • Thyroid warning. The US labels rule out both for anyone with a personal or family history of medullary thyroid cancer (MTC) or MEN 2; tell your doctor if this applies.1,3
Full detail in Guide 5: Side effects and risks →
Get help now: call 112. Call if you have severe stomach pain that won't go away, sometimes spreading to your back, with or without vomiting.2

What does each dose cost in India?

Each pen holds 4 weekly doses, and the MRP rises with the strength. These are printed MRPs, checked against our price index on 11 October 2026.

  • Ozempic: ₹5,660 (0.25 mg), ₹8,100 (0.5 mg) and ₹9,100 (1 mg) a pen.7,10,29
  • Wegovy: ₹5,660 (0.25 mg), ₹8,100 (0.5 mg), ₹9,100 (1 mg), ₹12,750 (1.7 mg) and ₹16,400 (2.4 mg) a pen.7,10,29
  • Poviztra: ₹3,999 (0.25 mg) to ₹8,999 (2.4 mg) for 4 weekly doses.15
  • Rybelsus: ₹8,916 to ₹9,510 (3 mg; listings differ), ₹9,900 (7 mg) and ₹10,884 (14 mg) for 30 tablets.21
  • Mounjaro: ₹13,125 (2.5 mg), ₹16,406 (5 mg), ₹20,625 (7.5 and 10 mg) and ₹25,781 (12.5 and 15 mg) a KwikPen.20 Yurpeak: same as Mounjaro, per Cipla, with no figure published.14

Ozempic 0.5 mg and Wegovy 1.7 mg are printed MRPs on pharmacy listings; Wegovy 0.5 mg and both 1 mg prices are Novo Nordisk's weekly prices × 4.10,29 Mounjaro and Rybelsus are printed MRPs on at least two pharmacy listings, as we found no maker statement.20,21 Brands are listed in the order of this page, not ranked.

A first year costs less than a year at the top dose, because the early steps are cheaper. What a year costs, all in adds doctor visits and blood tests.

Free toolPrice your own dose steps

Pick a medicine and the steps your doctor plans; it adds MRPs, visits and tests for 6 and 12 months. No sign-up.

Open the calculator

What if a dose is missed or a step is hard to bear?

Each label has its own missed-dose rule, and the weight labels let a doctor slow the climb if a dose isn't tolerated.

  • Ozempic: take a missed dose within 5 days, or skip it.1
  • Wegovy: take it if the next dose is more than 2 days away. After 2 or more missed doses in a row, the label restarts the steps at a lower dose.2 If a step isn't tolerated, the next can wait 4 weeks.2
  • Mounjaro: take a missed dose within 4 days, or skip it.3

Our missed-dose answer covers longer gaps, and stopping and restarting covers breaks.

Which one? What does a doctor weigh?

A doctor chooses the medicine first and the dose second. The dose chart only applies once that choice is made.

  • What it's for. In India, Ozempic and Rybelsus are approved for type 2 diabetes, Wegovy for weight, and Mounjaro for both.7,8,9
  • Injection or tablet. Rybelsus is a daily tablet, taken every morning on an empty stomach; Ozempic, Wegovy and Mounjaro are weekly injections.1,2,3,5
  • How the steps feel. Stomach side effects come mostly while the dose rises, which is why the climb is slow.2,4
  • The dose that works for you. The labels name more than one maintenance dose, and the lowest that does the job is a choice for you and your doctor.2,4
  • Cost at that dose. The MRP rises with the strength, so the dose you settle on sets the monthly bill.7,20

Our doctor questions tool builds a list for your visit.

Questions people ask

What is 5 mg of tirzepatide equal to in semaglutide?

There is no equal dose. Semaglutide and tirzepatide are different molecules, and none of the labels gives a conversion between them. A doctor who switches someone usually starts the new medicine on its own dose steps.1,3

What is the semaglutide dose for weight loss?

On the Wegovy label it starts at 0.25 mg a week and rises every 4 weeks to 2.4 mg, or 1.7 mg, chosen by response and side effects. Ozempic, sold in India up to 1 mg, is approved here for type 2 diabetes, not weight.2,7

What is the highest dose of Mounjaro?

15 mg once a week. It is reached in 2.5 mg steps, at least 4 weeks apart, so the earliest is week 21.3

Is 2.5 mg Mounjaro a maintenance dose?

No. The US Zepbound label, for the same tirzepatide, says 2.5 mg is only for starting; the doses to stay on are 5, 10 or 15 mg.4

Can you switch between an Ozempic injection and Rybelsus tablets at the same dose?

No. The tablet dose is far higher because only about 0.4% to 1% of a Rybelsus tablet is absorbed. The only switch the US label describes is from a 0.5 mg Ozempic injection to 7 or 14 mg Rybelsus tablets a day, started a week after the last injection.5

How we researched this

On 14 October 2026 we read the US labels for Ozempic (May 2026), Wegovy (June 2026), Rybelsus (January 2026), and Mounjaro and Zepbound (August 2026), and the EU product information for Wegovy and Mounjaro. We found no Indian pack leaflets online. We read the abstracts of STEP 1, STEP 2, SURMOUNT-1, SURPASS-2 and SURMOUNT-5.

Strengths sold in India and approvals come from dated news reports and makers' releases. Prices come from our price index: maker prices reported in the news where they exist, otherwise printed MRPs on at least two pharmacy listings. We never use discounted selling prices.

We did not build a conversion table between the medicines, because no label or guideline we read gives one.

Before you move on

  • Semaglutide and tirzepatide doses don't convert milligram for milligram.
  • Semaglutide injections start at 0.25 mg; tirzepatide starts at 2.5 mg; both step up at least 4 weeks apart.
  • India sells Ozempic up to 1 mg, Wegovy up to 2.4 mg and Mounjaro up to 15 mg.
  • Higher doses brought more weight loss and more stops for stomach effects in the trials.
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Sources

  1. Novo Nordisk. Ozempic (semaglutide) injection prescribing information, US label, not the Indian one, revised May 2026: recommended dosage (2.2), missed dose (2.1). PDF
  2. Novo Nordisk. Wegovy (semaglutide) prescribing information, US label, not the Indian one, revised June 2026: dosage escalation and maintenance (2.2), missed doses (2.4), limitations of use. PDF
  3. Eli Lilly. Mounjaro (tirzepatide) prescribing information, US label, not the Indian one, revised August 2026: dosage and missed doses (2.1), strengths (3). PDF
  4. Eli Lilly. Zepbound (tirzepatide) prescribing information, US label (the US weight brand of the same tirzepatide), revised August 2026: "The 2.5 mg dosage is for treatment initiation and is not approved as a maintenance dosage"; maintenance 5, 10 or 15 mg (2.2); limitations of use (1); adverse reactions by dose (6.1). PDF
  5. Novo Nordisk. Rybelsus and Ozempic (semaglutide) tablets prescribing information, US label, not the Indian one, revised January 2026: dosage (2.2), switching from Ozempic injection (2.4), "not substitutable on a mg-to-mg basis", bioavailability (12.3). PDF
  6. European Medicines Agency. Wegovy: EU product information, section 4.8 adverse reactions (pooled STEP 1–4: nausea 43.9% vs 16.1% on placebo). PDF
  7. Business Standard. As generics wave builds up, Novo Nordisk slashes Ozempic, Wegovy prices (Ozempic ₹5,660 to ₹9,100; Wegovy ₹5,660 to ₹16,400; "Ozempic is indicated for diabetes management, while Wegovy is prescribed for obesity and weight management"; Indian makers' semaglutide brands for diabetes or weight). 31 March 2026. Link
  8. BioSpectrum. Eli Lilly introduces Mounjaro (tirzepatide) for treatment of obesity and type 2 diabetes (CDSCO marketing authorisation). 20 March 2025. Link
  9. Medical Dialogues (Parthika Patel). Novo Nordisk gets CDSCO panel nod for Rybelsus label update ("indicated for the treatment of type 2 diabetes mellitus"; 3, 7 and 14 mg tablets). 10 September 2025. Link
  10. ThePrint (Reuters). Novo Nordisk again cuts Ozempic, Wegovy prices by up to 48% in India as generics flood market (Ozempic and Wegovy 1 mg ₹2,275 a week, from a Novo Nordisk statement). 1 April 2026. Link
  11. IndiaMedToday (IMT News Desk). Novo Nordisk's Wegovy gets CDSCO nod for adolescent obesity in India. 29 May 2026. Link
  12. Business Standard (Sanket Koul). Novo Nordisk's Wegovy gets CDSCO nod for fatty liver disease indication. 17 July 2026. Link
  13. Deccan Herald (PTI). Novo Nordisk launches anti-obesity drug Wegovy in India (strengths 0.25, 0.5, 1, 1.7 and 2.4 mg). 24 June 2025. Link
  14. Cipla. Cipla launches Yurpeak (tirzepatide) ("Lilly will manufacture and supply Yurpeak to Cipla, and the price will be the same as Mounjaro"; 2.5 to 15 mg). Press release, 10 December 2025. PDF
  15. Indian Pharma Post (IPP Bureau). Emcure Pharma reduces Poviztra starting dose price by 55% in India (Novo Nordisk's second semaglutide brand; 0.25 mg ₹3,999 to 2.4 mg ₹8,999 a month). 2 April 2026. Link
  16. PharmEasy, Tata 1mg, Medkart and MrMed product listings, printed MRP of Mounjaro single-dose vials (2.5 mg ₹3,281; 5 mg ₹4,102 a vial). Recorded in our price index, checked 11 October 2026. Not linked: we don't link pages that sell medicines.
  17. European Medicines Agency. Mounjaro: EU product information, section 4.8 adverse reactions. PDF
  18. Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med 2021;384:989–1002. Funded by Novo Nordisk. DOI · PMID 33567185
  19. Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). N Engl J Med 2022;387:205–216. Supported by Eli Lilly. DOI · PMID 35658024
  20. PharmEasy, Tata 1mg, Medkart and MrMed product listings, printed MRP of the Mounjaro KwikPen (4 doses): 2.5 mg ₹13,125; 5 mg ₹16,406; 7.5 and 10 mg ₹20,625; 12.5 and 15 mg ₹25,781. Recorded in our price index, checked 11 October 2026. Not linked: we don't link pages that sell medicines.
  21. PharmEasy, Tata 1mg, MrMed and Medkart product listings, printed MRP of Rybelsus per strip of 10 (7 mg ₹3,300; 14 mg ₹3,628; 3 mg ₹2,972 on most listings, ₹3,170 on PharmEasy since October 2026). Recorded in our price index, checked 11 October 2026. Not linked: we don't link pages that sell medicines.
  22. Davies M, et al. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2). Lancet 2021;397:971–984. Funded by Novo Nordisk. DOI · PMID 33667417
  23. Frías JP, et al. Tirzepatide versus semaglutide once weekly in patients with type 2 diabetes (SURPASS-2). N Engl J Med 2021;385:503–515. Open-label. Funded by Eli Lilly. DOI · PMID 34170647
  24. Aronne LJ, et al. Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5). N Engl J Med 2025;393:26–36. Open-label. Funded by Eli Lilly. DOI · PMID 40353578
  25. Niva Bupa. All about health insurance exclusion list updated from IRDAI ("Standard health insurance only pays out if you are admitted for medical treatment"). Checked 14 October 2026. Link
  26. Press Information Bureau (PIB Research). GLP-1 Drugs: Use, Risks, and Regulation ("In India, GLP-1 drugs can only be prescribed by endocrinologists, internal medicine specialists, and cardiologists"). 1 April 2026. PDF
  27. CDSCO. Recommendations of the Subject Expert Committee (Endocrinology & Metabolism), 20–21 April 2023, item 1, tirzepatide: "The drug should be sold by retail under prescription of Endocrinologist or internal medicine specialists only." PDF · archived copy
  28. CDSCO. Recommendations of the Subject Expert Committee (Endocrinology & Metabolism), 13–14 February 2024, items 3–4, semaglutide: "To be sold by retail on the prescription of an Endocrinologist, and Internal medicine". PDF · archived copy
  29. PharmEasy, MrMed and Apollo Pharmacy product listings, printed MRP per pen of 4 doses: Ozempic 0.5 mg ₹8,100; Wegovy 1.7 mg ₹12,750. Recorded in our price index, checked 11 October 2026. Not linked: we don't link pages that sell medicines.

Last checked 14 Oct 2026 · Next review due 14 Apr 2027 · Report an error

How this page was made. Written by the GLP Guidebook team from the sources above. It's general information, not medical advice. Talk to a qualified doctor before starting, stopping or changing any medicine. How we write